Heart Valve Infection Risk on the Rise in Hospitals

By John Commins, Healthleaders Media, September 30, 2019.

New infection sources have emerged for people with heart disease, and defective or artificial heart valves. That’s according to a new study from researchers at Rutgers Robert Wood Johnson Medical School, published this month in The American Journal of Cardiology.

The researchers warned that these potentially lethal cardiac infections pose an increasing threat to hospital patients admitted for other diseases. “In the past, infective endocarditis was associated with rheumatic heart disease and most often caused by bacteria in the mouth,” study lead author Abel Moreyra, MD, a professor of medicine at Rutgers, said in comments accompanying the study.

“However, new risk factors, such as intravenous opiate abuse, compromised immune systems, hemodialysis and implanted heart devices have emerged,” Moreyra said. In 2007, the American Heart Association revised guidelines and recommended antibiotics only for patients at high risk for infection.

The researchers looked to find how the revised guidelines changed infection rates. They analyzed 21,443 records of people who were diagnosed with infective endocarditis in New Jersey hospitals from 1994 to 2015.

The researchers were surprised to find that, beginning in 2004, there was a significant decline in the number of patients hospitalized with infective endocarditis as the primary diagnosis for their reason for admission.

Coupled with that was a significant increase in the number of patients developing the infection in the hospital, or a secondary diagnosis. In total, 9,191 people were hospitalized with infective endocarditis as the primary diagnosis and 12,252 with secondary diagnosis, the researchers found

The decline in primary diagnosis was attributed by researchers to improved dental care and the rarity of rheumatic heart disease, where streptococcus plays a key role in the infection.

“However, 60% of infective endocarditis that developed after admission were caused by a different microorganism, staphylococcus bacteria, which is abundant in hospitals and implicates health care as a possible source of infection,” Moreyra said.

The researchers believe that, by identifying the different time trends of primary and secondary diagnosis of infective endocarditis, the findings can help hospitals tailor different strategies for the prevention of this potentially lethal infection.